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==Overview==
==Overview==
Biopsy for lung mass may be classified into 2 categories: non-surgical biopsy and surgical biopsy. Biopsy findings associated with lung mass will depend on tumor [[histology]]. Common types of lung tissue biopsy for pulmonary mass, include: conventional bronchoscopic-guided transbronchial biopsy, bronchoscopic-transbronchial needle aspiration, endobronchial ultrasound-guided sheath transbronchial biopsy, and endobronchial ultrasound-guided transbronchial needle aspiration. Common indications for biopsy in lung mass, include: suspected lung cancer, malignant features (lymph node involvement).<ref name="pmid15347106">{{cite journal |vauthors=Podbielski FJ, Rodriguez HE, Brown AM, Blecha MJ, Salazar MR, Connolly MM |title=Percutaneous biopsy in evaluation of lung nodules |journal=JSLS |volume=8 |issue=3 |pages=213–6 |year=2004 |pmid=15347106 |pmc=3016799 |doi= |url=}}</ref>
[[Biopsy]] of a lung mass may be classified into 2 categories: non-surgical biopsy and surgical biopsy. [[Biopsy]] findings associated with lung mass will depend on [[tumor]] [[histology]]. Common types of [[lung]] [[Tissue (biology)|tissue]] [[biopsy]] for lung mass include conventional bronchoscopic-guided transbronchial biopsy, bronchoscopic-transbronchial needle [[aspiration]], endobronchial ultrasound-guided sheath transbronchial biopsy, and endobronchial ultrasound-guided transbronchial needle aspiration. Common [[Indication (medicine)|indications]] for [[biopsy]] in lung mass include suspected [[lung cancer]] and [[malignant]] features ([[lymph node]] involvement).


==Other Diagnostic Studies==
==Other Diagnostic Studies==
===Biopsy===
===Biopsy===
Biopsy for lung mass may be classified into 2 categories:<ref name="pmid15347106">{{cite journal |vauthors=Podbielski FJ, Rodriguez HE, Brown AM, Blecha MJ, Salazar MR, Connolly MM |title=Percutaneous biopsy in evaluation of lung nodules |journal=JSLS |volume=8 |issue=3 |pages=213–6 |year=2004 |pmid=15347106 |pmc=3016799 |doi= |url=}}</ref>
[[Biopsy]] of a lung mass may be classified into 2 categories:<ref name="pmid15347106">{{cite journal |vauthors=Podbielski FJ, Rodriguez HE, Brown AM, Blecha MJ, Salazar MR, Connolly MM |title=Percutaneous biopsy in evaluation of lung nodules |journal=JSLS |volume=8 |issue=3 |pages=213–6 |year=2004 |pmid=15347106 |pmc=3016799 |doi= |url=}}</ref>
:*Bronchoscopy
===1. Non-surgical Biopsy===
:*Transthoracic needle biopsy
:*Needle core biopsy
*'''Surgical'''
:* Wedge resection
* The preferred biopsy technique for lung mass is wedge resection.


*Indications for biopsy in lung mass, include:<ref name="pmid15347106">{{cite journal |vauthors=Podbielski FJ, Rodriguez HE, Brown AM, Blecha MJ, Salazar MR, Connolly MM |title=Percutaneous biopsy in evaluation of lung nodules |journal=JSLS |volume=8 |issue=3 |pages=213–6 |year=2004 |pmid=15347106 |pmc=3016799 |doi= |url=}}</ref>
'''Bronchoscopy'''
:*Suspected lung cancer
:*Determination of tumor histologic subtype
:*Characterization of genetic mutations


*Contraindications for biopsy in lung mass, include:<ref name="pmid15347106">{{cite journal |vauthors=Podbielski FJ, Rodriguez HE, Brown AM, Blecha MJ, Salazar MR, Connolly MM |title=Percutaneous biopsy in evaluation of lung nodules |journal=JSLS |volume=8 |issue=3 |pages=213–6 |year=2004 |pmid=15347106 |pmc=3016799 |doi= |url=}}</ref>
*Common [[bronchoscopy|bronchoscopic]] [[biopsy]] techniques for lung mass include:<ref name="pmid15347106">{{cite journal |vauthors=Podbielski FJ, Rodriguez HE, Brown AM, Blecha MJ, Salazar MR, Connolly MM |title=Percutaneous biopsy in evaluation of lung nodules |journal=JSLS |volume=8 |issue=3 |pages=213–6 |year=2004 |pmid=15347106 |pmc=3016799 |doi= |url=}}</ref>
:*Emphysema
**Conventional [[Bronchoscopy|bronchoscopic]]-guided [[Bronchial|transbronchial]] [[biopsy]]
:*Bullous disease
**[[Bronchoscopy|Bronchoscopic]]-[[Bronchial|transbronchial]] [[Needle aspiration biopsy|needle aspiration]]
:*Chronic respiratory failure
**Endobronchial [[ultrasound]]-guided sheath [[Bronchial|transbronchial]] [[biopsy]]
**Endobronchial [[ultrasound]]-guided [[Bronchial|transbronchial]] [[Needle aspiration biopsy|needle aspiration]]


*Complications for for biopsy in lung mass, include:<ref name="pmid15347106">{{cite journal |vauthors=Podbielski FJ, Rodriguez HE, Brown AM, Blecha MJ, Salazar MR, Connolly MM |title=Percutaneous biopsy in evaluation of lung nodules |journal=JSLS |volume=8 |issue=3 |pages=213–6 |year=2004 |pmid=15347106 |pmc=3016799 |doi= |url=}}</ref>  
*[[Indication (medicine)|Indications]] for [[bronchoscopy]] in lung mass include:<ref name="pmid15347106">{{cite journal |vauthors=Podbielski FJ, Rodriguez HE, Brown AM, Blecha MJ, Salazar MR, Connolly MM |title=Percutaneous biopsy in evaluation of lung nodules |journal=JSLS |volume=8 |issue=3 |pages=213–6 |year=2004 |pmid=15347106 |pmc=3016799 |doi= |url=}}</ref>
:*Pneumothorax
**Central [[nodules]]
:*Hemothorax
**Large [[Lesion|lesions]]
==Non-Surgical Biopsy==
**[[Contraindication]] to [[surgery]]
**[[Nodules]] close to the patent [[Airway|airways]]
**[[Patient|Patients]] who are at risk of [[Complication (medicine)|complications]] from other types of [[biopsy]] taking


'''Bronchoscopy'''
'''Transthoracic Needle Biopsy'''
*Usually done by [[CT]] guidance
*[[Indication (medicine)|Indications]] for transthoracic [[needle biopsy]] in pulmonary mass include:<ref name="pmid15347106">{{cite journal |vauthors=Podbielski FJ, Rodriguez HE, Brown AM, Blecha MJ, Salazar MR, Connolly MM |title=Percutaneous biopsy in evaluation of lung nodules |journal=JSLS |volume=8 |issue=3 |pages=213–6 |year=2004 |pmid=15347106 |pmc=3016799 |doi= |url=}}</ref>
**Peripheral [[nodules]]
**[[Nodules]] close to the [[chest wall]]
**[[Contraindication]] to [[surgery]]


*Common bronchoscopy biopsy techniques for lung mass, include:<ref name="pmid15347106">{{cite journal |vauthors=Podbielski FJ, Rodriguez HE, Brown AM, Blecha MJ, Salazar MR, Connolly MM |title=Percutaneous biopsy in evaluation of lung nodules |journal=JSLS |volume=8 |issue=3 |pages=213–6 |year=2004 |pmid=15347106 |pmc=3016799 |doi= |url=}}</ref>
===2. Surgical Biopsy===
:*Conventional bronchoscopic-guided transbronchial biopsy
:*Bronchoscopic-transbronchial needle aspiration
:*Endobronchial ultrasound-guided sheath transbronchial biopsy
:*Endobronchial ultrasound-guided transbronchial needle aspiration


*Indications for bronchoscopy in lung mass, include:<ref name="pmid15347106">{{cite journal |vauthors=Podbielski FJ, Rodriguez HE, Brown AM, Blecha MJ, Salazar MR, Connolly MM |title=Percutaneous biopsy in evaluation of lung nodules |journal=JSLS |volume=8 |issue=3 |pages=213–6 |year=2004 |pmid=15347106 |pmc=3016799 |doi= |url=}}</ref>
*[[excision|Surgical excision]] is the mainstay [[therapy]] for [[malignant]] lung mass.
:*Central nodules
*[[excision|Surgical excision]] is also the primary choice for the definitive [[diagnosis]] of [[malignant]] lung mass.
:*Large lesions
*In lung mass, [[Surgery|surgical procedure]] selection will depend on the size, margins, and location of the [[tumor]].
:*No fitness for surgery
*Common [[surgical procedures]] for the treatment of lung mass include:
:*Nodules close to the patent airways
**[[Wedge resection (lung)|Wedge resection]]
:*Patients were the risk of complications from any other biopsy is high
**[[Lobectomy of lung|Lobectomy]]
**Segmentectomy
**[[Lung]] volume reduction [[surgery]]


'''Transthoracic needle biopsy'''
==References==
*Usually followed by CT guidance
{{Reflist|2}}
*Indications for transthoracic needle biopsy in pulmonary nodule, include:<ref name="pmid15347106">{{cite journal |vauthors=Podbielski FJ, Rodriguez HE, Brown AM, Blecha MJ, Salazar MR, Connolly MM |title=Percutaneous biopsy in evaluation of lung nodules |journal=JSLS |volume=8 |issue=3 |pages=213–6 |year=2004 |pmid=15347106 |pmc=3016799 |doi= |url=}}</ref>
:*Peripheral nodules
:*Nodules close to the chest wall
:*No fitness for surgery


==Surgical Biopsy==
[[Category:Up-To-Date]]
*Surgical excision is the mainstay therapy for malignant lung mass
*Surgical excision is also the primary choice for the definitive diagnosis of malignant lung mass
*In lung mass, surgical procedure selection will depend on the size, margins, and size of the tumor.
*Common surgical procedures for the treatment of lung mass, include:
:*Wedge resection
:*Lobectomy
:*Segmentectomy
:*Lung volume reduction surgery
 
==References==
{{reflist|2}}
[[Category:Up-To-Date]]
[[Category:Oncology]]
[[Category:Oncology]]
[[Category:Medicine]]
[[Category:Medicine]]
[[Category:Pulmonology]]
[[Category:Pulmonology]]
[[Category:Surgery]]
[[Category:Surgery]]

Latest revision as of 20:20, 24 June 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2] Akshun Kalia M.B.B.S.[3]

Overview

Biopsy of a lung mass may be classified into 2 categories: non-surgical biopsy and surgical biopsy. Biopsy findings associated with lung mass will depend on tumor histology. Common types of lung tissue biopsy for lung mass include conventional bronchoscopic-guided transbronchial biopsy, bronchoscopic-transbronchial needle aspiration, endobronchial ultrasound-guided sheath transbronchial biopsy, and endobronchial ultrasound-guided transbronchial needle aspiration. Common indications for biopsy in lung mass include suspected lung cancer and malignant features (lymph node involvement).

Other Diagnostic Studies

Biopsy

Biopsy of a lung mass may be classified into 2 categories:[1]

1. Non-surgical Biopsy

Bronchoscopy

Transthoracic Needle Biopsy

2. Surgical Biopsy

References

  1. ↑ 1.0 1.1 1.2 1.3 Podbielski FJ, Rodriguez HE, Brown AM, Blecha MJ, Salazar MR, Connolly MM (2004). "Percutaneous biopsy in evaluation of lung nodules". JSLS. 8 (3): 213–6. PMC 3016799. PMID 15347106.
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